Our View: Budget concerns are threatening our health care

Here we go again. Congress is taking another run at reining in Medicare costs by cutting reimbursements to physicians. In December, doctors were given a a measly 0.5 percent increase. The next deadline is July 1, when members will hear the same arguments that forestalled the planned 10 percent reduction in payments.

Over the past seven years, Medicare reimbursements have been virtually flat while annual medical costs have doubled or tripled the rate of inflation. The squeeze on providers is contributing to a disturbing shortage of primary care physicians as the older ones retire and the younger ones gravitate to specialties that pay better. Plus, more and more doctors are refusing to take new Medicare patients and are cutting off longtime patients once they switch to Medicare, because reimbursements fail to cover the cost of care.

From 1997 to 2005, the number of medical school graduates choosing family practice has dropped by 50 percent. Because of aging baby boomers, the nation will need 39 percent more general practitioners by 2020, according to the American Academy of Family Physicians.

The shortage is being felt at basic levels of care, namely in community health centers, where 20 percent of slots for general practice in Washington state were vacant in 2006. As with emergency rooms, community health centers cannot turn away patients, but the shortage of doctors can mean delays in care.

To help combat the negative trend, the Legislature adopted the Health Professional Loan Repayment and Scholarship Program, which offers debt repayment assistance to doctors in exchange for three years’ service in underserved areas of the state and scholarships to medical students who choose family practice and agree to serve in places of need.

However, the program has not stopped the exodus of doctors from general practice to specialties as they seek ways to repay student debt that is typically in the hundreds of thousands of dollars. Certain areas of the state, usually rural, still suffer from a shortage of family care doctors.

So, the Community Health Network of Washington is asking the Legislature for a $3 million budget increase to augment the biennial funding of $6 million. The network estimates that such funding would put 50 more primary care providers into the loan program and steer 100 more students into family practice.

In Olympia and Washington, D.C., it is a tough budget year as the economy staggers, but the preventive care provided by general practitioners saves money in the long term. This nation will never reap the benefits of early care if it continually pinches those pennies.

Short-term budget arguments do not trump the long-term effectiveness of reinforcing the backbone of medical care. Governments need to continue to invest in basic care if we are to have any hope reversing the access-to-care crisis.